GREAT LAKES RADIOLOGY SERVICES – NPI #1891529111
Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Health Care Provider Taxonomy Code for Radiology

GREAT LAKES RADIOLOGY SERVICES is a radiologist located in PLYMOUTH, MI. NPPES has assigned the NPI number 1891529111 to GREAT LAKES RADIOLOGY SERVICES on August 28, 2024. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

The NPI profile was last updated on Sep 05, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GREAT LAKES RADIOLOGY SERVICES below.

NPI Profile for
GREAT LAKES RADIOLOGY SERVICES

NPI Number
1891529111
Enumeration Date

(about 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GREAT LAKES RADIOLOGY SERVICES
Primary location
729 W ANN ARBOR TRL STE 2
PLYMOUTH, MI 48170-6225
Phone: (734) 673-3764 Fax:
1 Other location(s):
4501 Bruce B Downs BLVD
Wesley Chapel, FL 33544-9216
Phone: (813) 914-1000
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BRIAN MADISON
ORGANIZER
Phone: (734) 673-3764
Updated
Certification Date
Sep 05, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0202X
- Radiology / Diagnostic Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.